Pairing keratoconus patients with the right contact lens requires a practitioner to gather data—some more valuable than others—about each patient’s specific malady and its severity, according to newly published research. A new study in Contact Lens & Anterior Eye found moderate and severe keratoconus patients do best with corneal rigid gas permeable and mini-scleral lenses. Milder cases are more appropriately fit with soft toric or hybrid lenses, the article concludes.

The study’s authors also found that undergoing corneal crosslinking for keratoconus does not affect the prescribed contact lens type. The location of the patient’s cone had no impact either; however, having central cone location and a history of crosslinking in rigid gas-permeable users improved visual acuity more efficiently, the authors noted.

The Turkey-based team examined the records of 195 keratoconus (301 eyes) patients who were prescribed contact lenses. The eyes were grouped according to the lens type to determine lens-corrected visual acuity (LCVA) and spectacle-corrected visual acuity (SCVA) levels. The difference between SCVA and LCVA was higher in patients who wore rigid gas-permeable lenses or mini-scleral lenses than in those who wore soft toric lenses.

With rigid gas-permeable lenses, eyes with central cones had a higher increase in visual acuity with contact lenses compared with eyes that had paracentral cones. Those patients’ increase in visual acuity with contact lenses was even higher when they received corneal crosslinking.

 “If appropriately chosen, all types of contact lenses could result in a good visual acuity level,” the authors concluded.

Sarac O, Kars M, Temel B, Cagil N. Clinical evaluation of different types of contact lenses in keratoconus management. Contact Lens and Anterior Eye. February 26, 2019. [Epub ahead of print].